Dr. A. T. Still Founder of Osteopathy
M. A. Lane
To Dr. A. T. Still, founder of osteopathy, belongs much if not most of the credit for the modern recognition of the fact that inflammations are, in reality, not diseases in themselves, but the results of the body's attempt to kill and cast out the harmful germs which, when they enter the body that is not sufficiently protected against them, produce what has been called "disease". In the preceding chapter we discussed the nature, effects and causes of infectious diseases, and related how osteopathy can and does not only change and relieve these diseases, but also cures them - that is, reduces their active effects to zero.

In former times inflammations were themselves regarded as diseases, and naturally enough, when one considers how very little was known concerning them. All true inflammations consist, according to the ancient definition of these peculiar changes in the tissues, of redness, swelling, heat and a certain amount of pain or discomfort. These were regarded as the "four cardinal signs" of an inflammation. The inflamed part became red, it was swollen as compared with the normal state, it was hotter (fever) than in the normal state, and there was always pain - great or small as the case may be. Now in so far as the inflammation was regarded as a disease - the effort of the old style medicine (the healing art) was naturally directed against the inflammation (not against the cause of it) - it was deemed desirable to stop the inflammation or "reduce" it, at the same time reducing the fever that accompanied it. It had been found that if blood in generous quantities be withdrawn from the veins, the fever in a diseased body would be reduced. Therefore, it was believed that bleeding was a good remedy against inflammation and it was commonly practiced by all the old doctors. The professors of the healing art gave up their old method of bleeding only after a most bitter fight. But even after exhaustively bleeding the patient had been abandoned as a therapy, it was still believed that it was the inflammation that constituted the essentials of the disease. In recent years, however, this belief has vanished, and the intelligent doctor of today knows that an inflammation, wherever found, is only the reaction of the body against the invading germs, or other destructive agents.


Why? Because inflammation primarily consists of an unusual quantity of blood being drawn to the part. Hence, the heat, the swelling, the redness and the pain; for the unusual swelling of the inflamed part causes pressure on the delicate nerve endings in the part, and this pressure causes pain.

Now when this unusual quantity of blood in the engorged and enlarged blood vessels of the part flows back into the general circulation, and the lymph that has exuded from the engorged blood vessels into the tissues of the inflamed part flows out into the lymph vessels - all signs of the inflammation disappear and the part has been restored to its normal condition.

Nature accomplishes this reaction in ways peculiar to the peculiar pathogenic germ that is causing the trouble. Sometimes pus is formed, as in boils or carbuncles; sometimes fibrin is formed, as in pneumonia, diphtheria, and other fibrin-forming inflammations; but whatever the peculiar reaction may be, it is always based on the principle that the blood and the cells of the blood and of other tissues aim first to counteract, destroy and remove the direct causes that are destroying the tissues. And when this has been done, repair of the destroyed parts naturally follows. All these facts are now well known to pathologists, but such knowledge is of comparatively recent growth, and there is no therapy that is based on these facts so firmly and scientifically as osteopathy.


To A. T. Still belongs the credit for having been one of the first, if not the very first, to perceive the great natural laws that underlie the facts as we write them. For what was Dr. Still's argument? It was this: Nature to cure the "disease" sent blood in unusual quantity to the part, thus producing an inflammation. When, now, the cure had been worked out by the inflammation, the symptoms subsided (that is the inflammation) and the tissue became nearer normal, if not quite so. But since this is nature's own way of curing, the use of any method which would send blood into the part, in greater quantity than nature itself could send it into the part, would assist nature and hasten the cure, or actually initiate a cure, where, if left alone, nature would never of itself be capable of sending in enough blood to do the business, with disaster or death in prospect as a. consequence.
Osteopathy, therefore, teaches that an inflammation is nature's own method of curing certain diseases called infections; and it further teaches that by artificially increasing the quantity of blood flowing into an infected place, natural results can be obtained in greater quantity, and much more quickly, than unassisted nature herself can obtain them. This teaching, from the standpoint of pure science, as this subject has been illuminated in recent years, is scientifically unassailable and it works!

But osteopathy does more than increase the inflammatory reaction of the blood in infections. We say that it must do more, otherwise there could be no really scientific way of accounting for the peculiar results which are the common experience of osteopathic treatment in certain infectious diseases as the grip, pneumonia and typhoid fever, when the poisons (toxins) made by the germs are diffused throughout all the circulation, and hence through all the tissues of the body.

Let us glance at a common infection that produces an inflammation typical of the pathogenic germ involved, and also typical of the location in the body where the germs are growing. This infection is known as furuncle or in common language boils. What is a boil? It used to be believed by the old doctors (and is still believed by the uniformed) that boils were an indication of "impurity of the blood" and that this "badness" or "impurity of the blood", was "coming out" in the boils. Hence the old school of drug doctors had certain "remedies" not only for boils but for all other eruptions on the skin, especially eruptions that had pus in them, and these remedies were called by the old doctors "depurants" or remedies that cleared the blood of pus (such as sarsaparilla or other "purifiers").


In the word "depurant" the syllable "pur" is the same word as "pus", so that depurants depusified the blood - took the pus out of the blood, according to this delusion. The theory was that the pus which came out was originally in the blood, else it could not come out! Now there is no pus in the blood, but there are certainly in the blood many millions of white cells which, when they increase in number and gather by the millions in some certain place, and are killed by the disease germs, which they take into themselves to rid the body of them and their poisons, form pus. Pus in reality consists chiefly of the dead white cells (the leucocytes, phagocytes) that have lost their lives in defending the body from the invading germs. An inflammation that forms pus is called a purulent inflammation; and a boil, or furuncle, as it is called by the pathologists, is one type of purulent inflammation presenting phases, or characters, peculiar to itself because of the place where it is growing, that is, in the skin. Boils are caused directly by the presence in the deep part of the skin, or under the skin, of a germ called staphylococcus pyogenes aureus-staphylococcus, because the little spherical germs grow in the form of bunches; pyogenes because this germ draws to the neighborhood in which it is multiplying the white cells of the blood that when dead form pus; and aureus because the colonies of the germ, when grown in pure cultures outside the body on a medium such as gelatin, or agar, in a test tube or other vessel, are golden in color, aureus meaning "golden" and nothing else. There are several different varieties of staphylococci, but this particular one is the most commonly concerned. Now this germ enters the body by passing down the microscopic space surrounding a hair. The individual germs are so small as to be distinctly visible only under very high powers of the microscope, say a magnification of about I,OOU diameters of the object itself. The individual germ is scarcely larger than about 1-25000 of an inch-a size so small as to surpass the power of the imagination. It can therefore have an easy passage in the smallest crevices, or chinks, or holes in the skin, and it actually makes its way into the deeper parts of the skin in this way.
Once in it finds itself surrounded by the richly nourishing fluid that nourishes the skin - the so-called lymph of the body, that passes out through the walls of the tiny capillaries that convey the blood to the remotest corners of the tissues. Here the germ finds a "medium" of growth and nourishment finer and richer than any artificial medium the bacteriologist can make in his laboratory, and the staphylococcus begins to multiply! In multiplying it throws off from its inconceivably minute body the excretions of its life growth, and these excretions are poisonous to the tissues. But they do not diffuse easily, so that the area of infection is more or less limited to the locality of the original entrance point. The tissue cells die and digest themselves, and the liquid substance produced by the auto-digestion diffuses around the place to the nearest blood vessels and attracts to the vicinity the white cells which, when they arrive at the spot where the germs are multiplying, ingest or engulf the bacteria and are killed by the germs. But the germs themselves are killed in their own turn by the white cells and in this way the pus is formed.


Meanwhile, the poisonous substances made by the bacteria and the dying tissues have caused a powerful flow of blood to the part, by causing the calibre of the little vessels to open out wide, letting in the blood by simple mechanical law of hydrostatics, so that previously to the pus formation the part becomes highly swollen, red and hot - in other words inflamed, and down through the center of the inflamed area is a plug of yellowish solid material, the "core" of the boil. This core consists of dead skin tissue, not yet all dissolved, filled with white-yellowish pus cells. The boil may "break" out on the surface of the skin - if the inflammation be rapidly formed - and with this release of the pus the germs are also carried out of the pocket and the injury heals rapidly leaving only a slight scar. If the development of the inflammation be slower, however, the "core" is formed, the subsequent repair is slower also, and the scar will be larger and deeper. But it is clear from what has been said that the more rapidly formed the inflammation, the more rapid will be the healing process. And the rapidity of the entire proceeding will be determined largely by the quantity of blood drawn to the part in the beginning of the infection.

Now if osteopathic treatment be given for a boil at the beginning of the inflammation, the excessive quantity of blood, over and above the natural quantity which is sent into the part by the treatment, will hasten the inflammation in an artificial way, and hence such an infection can be shortened in its course by just that much. And this has occurred in the treatment of boils by osteopathy.


We can partly explain these interesting facts in this way: A certain amount of blood is needed to neutralize the poisons and destroy the life of a certain number of germs in the tissues. If these germs did not multiply in number a given quantity of blood would do the work in a given time. But the number of germs is constantly growing, and inasmuch as nature itself can supply only a limited amount of blood in a given time, the inflammation must grow larger as the number of germs increase, and it must grow larger at a higher rate than the rate at which the number or germs grows; else the multiplication of the germs could never be stopped. The entire time required by nature to do the work is generally - when the germs are growing in the skin - about ten days; after which the inflammation subsides because the germs have been almost all killed. But it can be seen that if the rate at which the blood flows into the part be increased beyond the natural rate, the inflammation, just because it is increased out of its natural proportion, should be correspondingly shortened; and this is the actual fact.

But it would appear from this that there must be something in the blood that kills the germs. What is this thing?

To answer this question we must direct the attention of the reader to certain substances in the blood called opsonins by their discoverer, Sir Almroth E. Wright, of London. Opsonins are substances in the blood which have a chemical affinity for bacteria-the germs of disease-including staphylococcus pyogenes aureus. These substances unite with the bacteria so that the white cells can engulf them, thus killing them and removing them from the tissues and forming pus. If the blood of an individual be rich in the opsonin against this particular germ that causes boils, the few germs that enter the skin, or under it, are at once changed by their union with this special opsonin and the bacteria are now engulfed by the leucocytes.

The presence in the blood of these peculiar substances called opsonins, and their action in the way described, constitutes the immunity of the individual against the special germs against which the opsonins are directed. Upon these facts is based the great phagocytic theory of immunity, originated by the late Professor Elie Metchnikoff, of Paris, who died recently, and who has always been regarded by osteopaths with a certain reverence as having in a considerable degree explained by scientific experiments the remarkable effects of osteopathic treatment in certain infectious diseases. Osteopaths have also had much respect and admiration for Sir Almroth E. Wright, the Englishman who discovered and proved the presence in the blood of the opsonins, and thus entirely vindicated the original work of the great and powerful Metchnikoff. For the osteopath can see clearly how a local infection such as boils, if we assume the presence in the blood of the opsonin bodies (which are as truly "antibodies" as are the other antibodies so widely discussed today), can be abated and cured by causing the blood in larger quantities (and hence the opsonins in the larger quantities) to flow through the infected part.

There is another interesting fact about the results of osteopathic treatment in the case of boils, when the osteopathic doctor attacks this disease in time, that is, early after the appearance of the first redness and swelling.

Almost invariably whenever a boil appears it is followed by several new ones. Boils as a general rule come in crops. Why is this the fact? Because when the germ-containing pus breaks out on the skin, the germs are smeared over the unaffected skin, and some of these germs, being still alive and virulent, make their way into the skin, or under it, through the spaces alongside of the hairs of the skin - just a repetition of the original infection. This spread of the infection will go on until the skin, all around the original site of the infection, has become immune by the natural production of the anti-staphylococcic opsonin. The entire infection will now clear up-if the individual's body can make the opsonsin in sufficient quantity. When the reverse is true we have what is called "Chronic boils".


But if the patient has had osteopathic treatment in time, if blood has been thrown in liberal quantities into the part, the excess of the specific opsonin thrown into the blood causes, apparently, a certain peculiar change in the germs by which they are rendered less virulent, or more easily and quickly engulfed by the soldier cells of the blood, and hence when the original boil breaks, and these germs now enter the skin alongside the hairs, the germs are quickly disposed of by the phagocytes of Metchnikoff, and no second boil appears. The infection does not spread. These things occur also when the patient, for one or another reason, has been taking osteopathic treatment, and becomes infected by this peculiar germ. Only one boil appears and its course is quickly and mildly run, with comparatively little pain and no re-infection. Only one explanation of these peculiar facts can be given, and that is that osteopathic treatment not only makes full use of the quantity of opsonin naturally in the body, but also actually increases the total quantity of this opsonin naturally circulating in the blood.


Now this is the very result which Sir Almroth E. Wright has attempted to produce by his so-called vaccines, or dead staphylococci, which he injects into the blood of the patient suffering with boils, after having grown them from germs taken from the patient's own lesions. The world's bacteriologists and immunologists all agree in the verdict that Wright's claims must be exaggerated, for no one but Wright himself has been able to secure the results claimed by him. It is highly significant that osteopathy here, as elsewhere in the infectious diseases, seems quite competent to do the very things which the vaccine therapy theoretically should be able to do and cannot. It is not to be argued from this that Sir Almroth E. Wright is wrong in his experiments with the opsonins, for he certainly has made a prime discovery which, theoretically should be able to work cures in infections from these peculiar germs, but which fails in all but a comparatively few cases.  Neither Wright nor any other scientific investigator (outside of the osteopaths) has tried the effect on the work of opsonins by flushing the parts with larger quantities of natural blood than the normal inflammation contains. Osteopathy, by washing the inflamed part with increasing streams of normal blood actually brings larger supplies of normal opsonin to the part than could possibly flow to it normally; but it is also more than probable that the total amount of this antibody is increased by the treatment.


Somewhat similar phenomena appear when virulent tonsillitis is treated at the beginning of the infection by thorough osteopathic manipulation. That the virulence of bacteria (germs) can be sensibly lessened, and even quite destroyed, by osteopathic treatment, need not be doubted today ; and the time is not far away when scientific research will clear up much of the mystery that now puzzles osteopaths in the results they secure in the treatment of infectious diseases.

Tonsillitis in varying degrees of virulence can be caused by several entirely different germs, but typical painfully virulent tonsillitis, accompanied by systemic fever, is nearly always (la grippe aside) due to the growth in the tonsils of a pus-making germ called streptococcus pyogenes (streptococcus because the germs grow in the form of chains).
Not long ago a culture of streptococcus pyogenes was made from the throat of a child who had an intense inflammation of the tonsil accompanied by high temperature. The parents of the child had called in an osteopath at the very first appearance of the attack. The temperature (fever) was marked and the tonsil typical. But the osteopath (fortunately for the child if unfortunately for the experiment) had given the patient two thorough treatments before taking the "swab" from the throat. After the first treatment the fever had reduced almost to normal, and after the subsequent treatment the tonsils had been distinctly relieved and the fever almost all removed. The germs were still there in quantity, but when their virulence was tried out in a laboratory experiment, the germs were found to be quite harmless. Now it is only rational to conclude that the treatment had directly to do with the destruction of the virulence of this germ, for such a tonsillitis - if let alone - would normally run its usual course, and recovery take place only after the body had immunized itself against the germ by an increase in the anti-streptococcic bodies in the blood. Theoretically a vaccine should do what this osteopath did, but practically such a result is rare in vaccine therapy. The laws underlying these remarkable results of osteopathic treatment will certainly some day be established by scientific osteopathic research, but in the meantime the osteopathic practitioner can, in the interest of his patients, assume that his own theory of results is ample to account for them, and go on treating infectious diseases in the proved conviction that his peculiar form of mechano-therapy as worked out by Dr. A. T. Still actually and practically does what serum and vaccine therapy should invariably do but unfortunately does not.
One of the most remarkable results in the osteopathic treatment of infections, familiar from of old to all practitioners and even students of this art, is the result in acute and chronic dysentery. Dysentery (diarrhoea) is most frequently caused by the growth in the intestine of one of the several types of germs producing the typical flux from the intestine. Pressure on the spine (in a way peculiar to osteopathic theory and practice) quickly stops dysentery when caused by these germs. The treatment is familiarly known to osteopathic doctors as "inhibition". Dr. A. T. Still early demonstrated the entire curability of dysentery by this method in quickly restoring to normal a number of children afflicted in this way. His early success has been followed up ever since that time by the members of his school who have come to regard this kind of dysentery as a simple matter for the osteopath to cure.


What is the drug treatment for dysentery? There are two methods opposite in theory and practice. One is to clean out the intestine with a purgative, the other is to paralyze the intestine by drugs such as chloroform. Capsicum (red pepper) and chloroform will often suddenly stop the movement of the intestines in dysentery, but never as quickly as osteopathic inhibition. The chloroform may act as an inhibition of the growth of the germs, but this inhibition is not at all what is meant by the osteopath when he uses that word. Osteopathic inhibition is temporary stoppage of the movement of the intestine, and this stoppage is entirely free from the after effect which follows the use of the drug. Permanent recovery quickly ensues, and in some way the multiplication of the germs in the intestine is stopped. Possibly this growth is stopped by the accumulation of their own secretion products in the intestine, but more probably by the production in the blood of the intestines of substances that escaping into the intestines do the damage to the germs there. It is difficult to account for the results of osteopathic treatment in dysentery unless some back bone lesion is assumed to exist even where it is invisible; but the certainty of the results is one of the most remarkable and interesting of the innumerable interesting facts of the osteopathic therapy.


When we say that osteopathic treatment reduces the virulence of disease germs, we can only mean one thing, and that is that osteopathic treatment increases the body's resistance to the germs in question once the germs are in and multiplying. No definite experimental proof has ever been established that the body's resistance to disease germs can be increased by osteopathic treatment before an infection is introduced into the body. That is to say, it has not yet been experimentally proved that osteopathic treatment can so increase the body's resistance to all germs that this treatment can be absolutely regarded as a preventative of infection, as for example when vaccine for typhoid fever prevents the individual treated from acquiring typhoid fever. And yet, pending such experimental evidence, the osteopath is warranted in assuming that general osteopathic treatment actually does accomplish some such body change, for we know as a matter of fact that osteopathic treatment vastly increases those normal reactions of the body which are, in fundamental physiology, physiologically similar to the body's reactions against infectious germs and their toxins.


For example, an osteopathic treatment when one is tired and exhausted after a day's hard work will wonderfully refresh the body and restore its vigor, producing a physiological reaction very nearly equivalent to a good night's sleep. This is a fact familiar to all osteopaths, many of whom are eager to get such a treatment for themselves whenever a friendly fellow practitioner is near by and agreeable. Now what does this reaction mean? If it means anything it means that the osteopathic manipulation of the spine actually does what sleep will do for a similarly tired man. And sleep, it is known, refreshes and strengthens the body in all its parts, and in all its cells, by neutralizing the poisons released by the work of the body's cells in their activities during the waking state. The nerve cells, the muscle cells and all the other cells (but principally these two master tissues) work, and in working throw out of themselves into the blood stream certain chemical waste substances which react on the nerve cells as toxins - the toxins of fatigue. During sleep the body cells manufacture antibodies that neutralize the fatigue toxins, and the nerve cells therefore feel fresh again. Simple feeding of the nerve cells is not sufficient. These fatigue substances must be neutralized and several hours are necessary to do it - hours during which no further fatigue toxins are made by muscle and nerve. But osteopathic treatment will encompass after 30 minutes what otherwise requires several hours of sleep. Thus does osteopathic treatment stimulate the body to the rapid production of antibodies against normal toxins made by the normal activities of the normal boy's cells.

Now the toxins of disease are toxins not made by the body's own cells, but by the foreign cells called disease germs, and it is reasonable to say that the effect of osteopathic treatment on the normally tired body is regulated by the same physiological law that underlies the production of antibodies to the toxins of disease.